Jurnal Anestesi dan Terapi Intensif Udayana
JATI (Jurnal Anestesi dan Terapi Intensif) Udayana publishes original research articles, review articles, and case reports in the field of anesthesiology and intensive care. The journal aims to advance knowledge, research, and clinical practice in the following areas: General Anesthesia Advances, techniques, and innovations in general anesthesia practice for various age groups and surgical procedures, including: Thoracic, Cardiac, and Vascular Anesthesia Neuroanesthesia Pediatric Anesthesia Ophthalmic Anesthesia Ear, Nose, and Throat (ENT) Anesthesia Oncologic Anesthesia Orthopedic Anesthesia Obstetric Anesthesia Urologic Anesthesia Digestive Surgery Anesthesia Plastic Surgery Anesthesia Trauma Anesthesia Minimally Invasive Surgery Anesthesia Anesthesia Outside the Operating Room (Non-OR Anesthesia) One-Day Care Anesthesia Regional Anesthesia Research and clinical application of neuraxial and peripheral nerve blocks, including ultrasound-guided and nerve stimulator-assisted techniques. Intensive Care and Critical Medicine Topics related to the management of critically ill patients, including hemodynamic monitoring, sepsis, organ support, and intensive care protocols. Acute and Chronic Pain Management Perioperative pain control, chronic pain interventions, multimodal analgesia, and opioid-sparing techniques. Emergency and Resuscitation Clinical and experimental research on resuscitation, trauma management, cardiac arrest, and perioperative emergencies. Mechanical Ventilation and Monitoring Innovations in respiratory support, weaning strategies, and advancements in perioperative and critical care monitoring. Basic Anesthesia Sciences and Clinical Pharmacology Studies on pharmacokinetics, pharmacodynamics, anesthetic mechanisms, and physiology relevant to anesthesia practice. Ethics and Patient Safety Issues related to informed consent, safety culture, medical errors, ethical dilemmas, and risk mitigation in anesthesia and critical care practice. Medical Law Covers legal aspects of anesthesiology, intensive care, and perioperative medicine, including informed consent, medical confidentiality, patient–physician rights and responsibilities, medical litigation, and the application of bioethical principles in clinical decision-making and risk management. Anesthesia Medical Education Educational strategies, curriculum development, simulation-based training, and assessment methods for anesthesiology residents and professionals.
Articles
26 Documents
<![CDATA[Managemen Anestesi pada Congenital Diapragmatic Hernia dengan Ventrikel Septal Defek dan Atrium Septal Defek pada Pasien Pediatrik : Laporan Kasus ]]>
<![CDATA[Mauritius Septa]]>;
<![CDATA[Adinda Putra Pradhana]]>;
<![CDATA[I Putu Kurniyanta]]>;
<![CDATA[Ketut Wibawa Nada]]>;
<![CDATA[Novandi Kurniawan]]>;
<![CDATA[Tjokorda Gde Agung Senapathi]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/JATI.2025.v01.i02.p06
<![CDATA[Congenital diaphragmatic hernia (CDH) merupakan kelainan kongenital pada diafragma yang terjadi pada pediatri. Insiden terjadinya hernia tipe Borchdalek lebih sering terjadi pada sisi kiri dari pada sisi kanan. Penyulit lain pada CDH adalah hipoplasia paru, hipertensi paru dan kelainan pada jantung. Pada kasus ini kami mendiskusikan bayi 12 hari dengan kelainan CDH sisi kanan dengan kelainan jantung berupa ventrikel septal defek (VSD) dan atrium septal defek (ASD) yang dilakukan operasi laparotomi hernia. Manajemen anestesi pada pasien ini menggunakan inhalasi sevoflurane, fentanil, volume tidal rendah, obat inotropik dengan kondisi hemodinamik yang stabil selama pembedahan. Kami melaporkan management anestesi dengan sevoflurane yang dikombinasi dengan volume tidal rendah dan inotropik dobutamine pada operasi congenital diaphragmatic herdia dengan VSD dan ASD membantu dalam keberhasilan intraoperatif. Setelah operasi, pasien dilakukan perawatan di NICU untuk perawatan secara ketat.]]>
<![CDATA[External Oblique Intercostal Plane Block (EOIPB) sebagai Tambahan Analgesia Multimodal Pasca Laparoskopi Kolesistektomi: Tinjauan Naratif ]]>
<![CDATA[David Rendra Mahardika]]>;
<![CDATA[Made Agus Kresna Sucandra]]>;
<![CDATA[Tjokorda Gde Agung Senapathi]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/JATI.2025.v01.i02.p07
<![CDATA[Pendahuluan: Nyeri pascaoperasi, terutama setelah kolesistektomi laparoskopi, adalah masalah signifikan yang meningkatkan morbiditas dan memperpanjang masa rawat inap. Penanganan nyeri sering kali melibatkan opioid sistemik yang memiliki efek samping merugikan. Oleh karena itu, pendekatan analgesia alternatif yang minim opioid sangat dibutuhkan. Tinjauan naratif ini bertujuan mengevaluasi efektivitas External Oblique Intercostal Plane Block (EOIPB) sebagai tambahan analgesia multimodal pasca kolesistektomi laparoskopi, berfokus pada kualitas analgesia, pemulihan pasien, dan respons inflamasi sistemik. Metode: Tinjauan naratif ini didasarkan pada penelusuran literatur terstruktur dari PubMed, Scopus, ScienceDirect, Cochrane Library, dan Google Scholar. Pencarian menggunakan kombinasi kata kunci seperti "external oblique intercostal plane block", "laparoscopic cholecystectomy", "postoperative pain", "quality of recovery", "neutrophil to lymphocyte ratio", dan "platelet to lymphocyte ratio". Publikasi dibatasi pada tahun 2019–2024, berbahasa Inggris atau Indonesia. Kriteria inklusi meliputi studi primer peer-reviewed (RCT, kohort, observasional) yang mengevaluasi EOIPB atau blok interfasial sebanding, serta melaporkan skor nyeri pascaoperasi, konsumsi opioid, skor quality of recovery (QoR-15), dan/atau nilai neutrophil to lymphocyte ratio (NLR) / platelet to lymphocyte ratio (PLR). Hasil: EOIPB secara konsisten memperpanjang durasi analgesia, menurunkan intensitas nyeri dengan skor visual analog scale (VAS), dan mengurangi konsumsi opioid pascaoperasi secara signifikan. Studi juga menunjukkan profil keamanan EOIPB yang baik dengan insiden efek samping minimal. Bupivakain, agen anestesi lokal yang umum digunakan, tidak hanya memblok transmisi nyeri tetapi juga menunjukkan sifat anti-inflamasi. Meskipun demikian, terdapat heterogenitas dalam teknik dan jenis anestesi yang digunakan antar studi. Kesimpulan: EOIPB adalah teknik blok interfasial yang efektif dan aman untuk manajemen nyeri pasca kolesistektomi laparoskopi, memberikan analgesia yang lebih baik dan mengurangi kebutuhan opioid. Namun, masih diperlukan penelitian lanjutan berskala besar, terstandarisasi, dan multicenter untuk memperkuat bukti ilmiah dan mengevaluasi dampak jangka panjangnya.]]>
<![CDATA[Albumin Use and Its Association with Nutritional Status in the Intensive Care Unit : A Narrative Review ]]>
<![CDATA[Putu Eka Nantha Kusuma]]>;
<![CDATA[Jeremy Jonathan]]>;
<![CDATA[Putu Agus Surya Panji]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/JATI.2025.v01.i02.p08
<![CDATA[Introduction: Albumin is the major protein in blood plasma that plays a pivotal role in the regulation of oncotic pressure and nutritional status, particularly in critically ill patients. Hypoalbuminemia is frequently observed in ICU patients and is associated with increased morbidity and mortality. This narrative review aims to assess the role and efficacy of albumin supplementation, administered both orally and intravenously, in supporting the nutritional status and prognosis of critically ill patients. Methods: A literature search was conducted across the PubMed, Google Scholar, ScienceDirect, and ProQuest databases utilizing the keywords: "albumin", "critical illness", "nutrition", and "ICU". Articles included were those published within the last 10 years, available in English and Indonesian, and comprised review articles, clinical trials, and clinical practice guidelines. The selection process was performed through the screening of titles, abstracts, and subsequent full-text reviews. A total of 23 articles were included in this review. Results: The literature indicates that albumin supplementation contributes to hemodynamic stability, a reduction in nosocomial infections, and improved prognosis in patients with conditions such as sepsis, ARDS, hepatic and renal dysfunction, and in post-operative states. Supplementation with snakehead fish (Channa striata) extract has also been reported to increase albumin levels. Accurate nutritional assessment, using tools like the Nutrition Focused Physical Exam (NFPE), Subjective Global Assessment (SGA), and biomarkers such as Total Lymphocyte Count (TLC) and Neutrophil to Lymphocyte Ratio (NLR) are essential for determining the nutritional status of critically ill patients. Specific recommendations from the ESPEN consensus and various hepatology and nephrology associations exist concerning the application of albumin in specific clinical conditions. Conclusion: Albumin supplementation holds significant potential in supporting the nutritional status and improving the clinical outcomes of critically ill patients. Further studies are required to determine optimal protocols and the cost-effectiveness of albumin therapy in the critically ill patient population.]]>
<![CDATA[Transformasi ICU Modern: Teknologi, Humanisasi, dan Perawatan Individual dalam Era Perawatan Kritis ]]>
<![CDATA[I Made Prema Putra]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/JATI.2025.v01.i02.p01
<![CDATA[Transformasi ICU modern ditandai oleh kemajuan teknologi, pendekatan humanistik, dan perawatan individual yang terintegrasi. Penerapan ICU Liberation Bundle (ABCDEF) terbukti mengurangi durasi rawat, delirium, dan meningkatkan survival jangka panjang. Inovasi seperti kecerdasan buatan, tele-ICU, serta pemantauan hemodinamik lanjutan memperkuat deteksi dini dan intervensi tepat waktu. Strategi manajemen cairan berbasis responsivitas dinamis dan ventilasi protektif semakin diutamakan. Penggunaan ECMO dan imunoterapi untuk sepsis menunjukkan perkembangan signifikan. Meski demikian, tantangan seperti burnout tenaga kesehatan dan rehabilitasi pasca-ICU masih perlu diatasi. Kolaborasi dan inovasi terus menjadi kunci dalam membentuk ICU masa depan yang lebih adaptif dan berpusat pada pasien.]]>
<![CDATA[Comparison of IL-6 Levels After Ibuprofen–Paracetamol– Dexamethasone in Percutaneous Nephrolithotomy Patients: an Analytic Observational Study ]]>
<![CDATA[Rozi, Fakhriyadi]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/5xdehe52
<![CDATA[Introduction: Percutaneous Nephrolithotomy (PCNL) is the therapeutic procedure of choice for kidney stones. IL-6 secretion is stimulated during a secondary inflammatory response due to tissue injury or infection. Proper administration of analgesics can reduce morbidity rates, reduce treatment days, and reduce financing. Patients and Methods: An analytical observational study with a cross-sectional design at Purwokerto tertiary hospital in the period from December 2024 to January 2025 in patients undergoing PCNL procedures and receiving ibuprofen, paracetamol, and dexamethasone therapy, which met the inclusion and exclusion criteria. The observational group (15 patients each) was: Group A 1000 mg paracetamol and 400 mg ibuprofen and 5 mg dexamethasone; Group B 1000 mg paracetamol and 400 mg ibuprofen. IL-6 levels were measured before and 2 hours after the PCNL procedure. IL-6 levels were measured by ELISA (enzyme-linked immunosorbent assay). Comparative analysis of pre- or post-PCNL IL-6 levels by type of analgesic using unpaired t-test, while the comparison of changes in IL-6 levels was analyzed with the Mann-Whitney test. To determine whether the data distribution was normal, we used the Shapiro-Wilk test. The analysis used SPSS version 25. Results: Pre- and post-PCNL IL-6 levels were significantly lower in Group A compared to Group B (p < 0.05). However, changes in IL-6 levels were not statistically significant (p = 0.787). Effect size analysis indicated only a small and clinically negligible difference. Conclusion: There was no significant difference in IL-6 levels post-PCNL between the two observation groups.]]>
<![CDATA[Low-Flow Anesthesia Management in Pediatric Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Report ]]>
<![CDATA[Togi Stanislaus Patrick]]>;
<![CDATA[Aribawa, I Gusti Ngurah Mahaalit]]>;
<![CDATA[Ra Ratumasa, Marilaeta Cindryani]]>;
<![CDATA[Anak Agung Gde Adistaya]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/xqsck350
<![CDATA[Laparoscopic surgery offers significant benefits in pediatric populations but presents anesthetic challenges, especially during prolonged procedures. This case report describes the anesthetic management of an 11-year-old boy who underwent nearly 12 hours of laparoscopic choledochal cyst excision, Roux-en-Y hepaticojejunostomy, and cholecystectomy. Low-flow anesthesia using sevoflurane was administered via a Dräger Perseus A500, enabling precise control of anesthetic delivery, oxygenation, and ventilation. Throughout the procedure, inspired oxygen fraction (FiO₂) was maintained above 30%, and end-tidal CO₂ (EtCO₂) remained stable around 35 mmHg. Volatile agent consumption was reduced, with age-adjusted MAC (xMAC) consistently between 0.85 and 0.90. Intraoperative hemodynamics and postoperative recovery were stable, with no immediate complications. This case highlights the safety, efficiency, and cost-effectiveness of low-flow anesthesia in complex pediatric laparoscopic surgery when guided by advanced monitoring systems and supports its broader adoption in resource-limited healthcare settings.]]>
<![CDATA[Efektivitas dan Keamanan Deksmedetomidine Nebulisasi Dibandingkan Rute Intravena sebagai Premedikasi Anestesi: Tinjauan Naratif ]]>
<![CDATA[Katarina, Ida]]>;
<![CDATA[I Putu Fajar Narakusuma]]>;
<![CDATA[Made Septyana Parama Adi]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/93296c76
<![CDATA[Laringoskopi dan intubasi trakea merupakan prosedur rutin anestesi yang sering memicu respons hemodinamik berupa peningkatan tekanan darah dan denyut jantung, yang dapat berisiko pada pasien dengan komorbiditas kardiovaskular atau serebrovaskular. Deksmedetomidine, agonis reseptor α2 adrenergik selektif, terbukti efektif dalam menekan respon tersebut melalui efek simpatolitik dan sedatif. Namun, pemberian intravena sering menyebabkan efek samping berupa hipotensi dan bradikardia. Tinjauan naratif ini bertujuan membandingkan efektivitas dan profil keamanan deksmedetomidine nebulisasi dengan rute intravena sebagai agen premedikasi untuk mengontrol respon hemodinamik selama laringoskopi dan intubasi. Berdasarkan hasil sintesis, deksmedetomidine nebulisasi mampu menurunkan lonjakan tekanan darah dan denyut jantung secara efektif dengan insidensi hipotensi dan bradikardi yang lebih rendah dibandingkan pemberian intravena, serta mengurangi kebutuhan obat induksi anestesi tanpa menimbulkan komplikasi serius. Dengan demikian, deksmedetomidine nebulisasi berpotensi menjadi alternatif premedikasi yang efektif dan lebih aman untuk stabilisasi hemodinamik selama anestesi, meskipun masih diperlukan uji klinis multisenter berskala besar untuk memperkuat bukti dan menentukan dosis optimal.]]>
<![CDATA[Graded Epidural Anesthesia with Real-Time Hemodynamic Monitoring for Cesarean Delivery in Severe Mitral Stenosis: A Case Report ]]>
<![CDATA[Kurniady, Stephanie]]>;
<![CDATA[EM, Tjahya Ariyasa]]>;
<![CDATA[Putra Pradana, Adinda]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/fefrfk17
<![CDATA[This case report highlights the successful management of a high-risk obstetric patient with severe rheumatic mitral stenosis (MS) and acute decompensated heart failure (ADHF) using graded epidural anesthesia guided by real-time hemodynamic monitoring. A 34-year-old woman, in her second pregnancy following a previous abortion, presented at 34 weeks and 5 days of gestation with progressive dyspnea and orthopnea. Echocardiography confirmed severe MS accompanied by pulmonary hypertension and preserved left ventricular systolic function. After multidisciplinary optimization, an elective cesarean delivery was performed under graded epidural anesthesia with incremental dosing of lidocaine and ropivacaine. Beat-to-beat cardiac output monitoring using the MostCare™ PRAM (Pressure Recording Analytical Method) system guided vasopressor titration with phenylephrine, maintaining hemodynamic stability. The patient remained hemodynamically stable throughout the intraoperative and postoperative periods, with no pulmonary edema or arrhythmias, and was discharged on postoperative day four. This case demonstrates that graded epidural anesthesia, when combined with advanced hemodynamic monitoring and collaborative care, represents a safe and effective alternative to general anesthesia in parturients with severe valvular heart disease.]]>
<![CDATA[Dexmedetomidine pada Blok Torakolumbar Interfasial Plane Modifikasi: Tinjauan Naratif ]]>
<![CDATA[Ariyasa, I Putu Eka]]>;
<![CDATA[I Made Gede Widnyana]]>;
<![CDATA[I Made Agus Kresna Sucandra]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/s4tbj786
<![CDATA[Nyeri pascaoperasi merupakan tantangan klinis utama pada pasien yang menjalani bedah tulang belakang lumbal. Pendekatan analgesia multimodal semakin berkembang, dan blok interfasial torakolumbal (Thoracolumbar Interfascial Plane/TLIP) menjadi salah satu teknik yang efektif dalam mengurangi nyeri dengan risiko minimal terhadap fungsi motorik. Modifikasi teknik TLIP, terutama dengan penambahan adjuvan seperti dexmedetomidine, menawarkan potensi peningkatan durasi dan kualitas analgesia. Tinjauan naratif ini bertujuan merangkum bukti terkini mengenai efektivitas, mekanisme, dan keamanan penggunaan dexmedetomidine sebagai adjuvan pada TLIP modifikasi untuk bedah lumbal. Pencarian literatur dilakukan melalui basis data PubMed, Scopus, dan Google Scholar dengan menggunakan kata kunci “modified TLIP block”, “dexmedetomidine”, “lumbar spine surgery”, dan “postoperative analgesia” untuk artikel berbahasa Inggris atau Indonesia yang diterbitkan antara tahun 2013 hingga 2024. Hasil sintesis menunjukkan bahwa penambahan dexmedetomidine (0,5–1 µg/kg) pada anestesi lokal dapat memperpanjang durasi analgesia hingga 6–8 jam, menurunkan skor nyeri pascaoperasi, serta mengurangi konsumsi opioid tanpa menimbulkan efek samping berat, seperti bradikardia atau hipotensi yang signifikan. Efek analgesik ini terkait dengan aktivasi reseptor α₂-adrenergik di perifer dan spinal yang menghambat transmisi nyeri. Tinjauan ini membahas secara komprehensif dasar fisiologi dan farmakologi kombinasi TLIP–dexmedetomidine, perbandingan dengan blok interfasial lain, bukti klinis terkini, serta arah penelitian yang diperlukan untuk penerapan optimal dalam praktik anestesiologi modern.]]>
<![CDATA[Efektivitas dan Risiko Pemberian Antibiotik Profilaksis Ceftriaxone pada Pasien Cedera Otak Akut: Tinjauan Naratif ]]>
<![CDATA[Pita, Mora Lesmana]]>;
<![CDATA[Suranadi, I Wayan]]>;
<![CDATA[Nada, I Ketut Wibawa]]>
<![CDATA[ Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025 ]]>
Publisher : <![CDATA[Udayana University and Indonesian Society of Anesthesiologists (PERDATIN) ]]>
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DOI: 10.24843/ygnrw562
<![CDATA[Cedera otak akut merupakan salah satu penyebab utama mortalitas dan morbiditas pada pasien trauma dan sering disertai komplikasi infeksi nosokomial seperti ventilator-associated pneumonia (VAP) dan meningitis. Penggunaan antibiotik profilaksis, termasuk ceftriaxone, banyak diterapkan untuk mencegah komplikasi tersebut karena spektrum kerjanya yang luas dan kemampuannya menembus sistem saraf pusat. Namun, efektivitas dan dampak terhadap resistensi antimikroba masih menjadi perdebatan, terutama dalam konteks praktik intensif dan bedah saraf. Tinjauan naratif ini bertujuan untuk menilai efektivitas, keamanan, dan implikasi klinis pemberian ceftriaxone sebagai antibiotik profilaksis pada pasien cedera otak akut. Berdasarkan hasil uji klinis acak dan kajian sistematis, ceftriaxone menunjukkan penurunan kejadian VAP dini sebesar 14% dibandingkan 32% pada kelompok kontrol, tetapi tidak menunjukkan manfaat signifikan terhadap pencegahan meningitis atau infeksi luka operasi. Beberapa studi juga melaporkan peningkatan risiko resistensi bakteri akibat pemberian berkepanjangan. Hasil sintesis ini menegaskan pentingnya pendekatan selektif dalam pemberian antibiotik profilaksis dengan mempertimbangkan risiko infeksi dan prinsip antimicrobial stewardship. Pesan utama dari tinjauan ini adalah perlunya kebijakan penggunaan antibiotik yang lebih rasional dan penelitian prospektif untuk menentukan populasi pasien yang paling diuntungkan serta durasi optimal pemberian profilaksis.]]>
